Evaluation of hematological parameters in coronavirus disease 2019: Comparison between intensive care unit and non-intensive care unit patients

Abstract

Abstract Background: There are ongoing waves of coronavirus disease 2019 (COVID-19) infection with many variants of this disaster, the latest being BF.7 are prevalent now as of December 25, 2022. There are various changes observed in the clinical, hematological, and biochemical parameters in the patients getting infected by COVID-19. At present, the knowledge of the disease and its severity are important for patient management and prediction of patient outcomes. The study aimed to analyze and compare the differences in the routine hematological parameters of intensive care unit (ICU) and non-ICU COVID-19 groups since their admission. Materials and Methods: A retrospective study conducted at a tertiary care hospital in New Delhi for 9 months from March 1, 2020 to November 30, 2020. Routine hematological data confirmed of COVID-19 cases, who were admitted in ICU or non-ICU were retrieved from the Departments of Pathology and Critical Care Medicine and analyzed. The hematological parameters comprising platelet count (109/L), hemoglobin concentration (g/dL), leukocyte count (LEU, 109/L), neutrophil count (NEU, %), eosinophil count (EO, %), lymphocyte count (LYM, %), and monocyte count (MONO, %) and their derivatives such as neutrophil-lymphocyte ratio (NLR) were evaluated. Results: The study showed that there was a significant difference (P < 0.05) in the value of hematological parameters between ICU and non-ICU patients with higher levels ofLEU, NEU, and NLR in the ICU group compared to the non-ICU group confirmed COVID-19 positive patients. It was also observed that there was significantly higherLEU, higher NEU count, higher NLR and lower EO, LYM, and MONO count in deceased COVID-19 patients compared with recovered COVID-19 patients (P < 0.05). Conclusion: This study helps in understanding the role of hematological parameters especially increased LEU count, higher NEU count, higher NLR, and LYM in severely infected COVID-19 positive patients, admitted in ICU-care settings and deceased COVID-19 patients. It also helps us in deriving a hypothesis that among all hematological parameters, the reduced LYM count can be a very specific prognosticator of the infected patients. Therefore, these hematological parameters can act as a biomarker to recognize the severity of the disease and to monitor the clinical course of COVID-19.